Analysis of Bowel Sounds Application Status for Gastrointestinal Function Monitoring in the Intensive Care Unit

Abstract

The auscultation of bowel sounds (BS) has been neglected as a reliable tool for determining gastrointestinal (GI) functioning in the critically ill patient. This article considers the validity of BS auscultation in the assessment and management of critically ill patients and outlines how the information may be utilized for monitoring GI function. A descriptive, cross-sectional design with self-administered questionnaires was used to survey 132 nurses and 38 doctors in the 6 general intensive care units in Beijing hospitals. Descriptive statistics and chi-square test analyses were used to assess the level of knowledge about BS among Chinese doctors and nurses and to determine how they applied their BS auscultation findings in the care of critically ill patients. Bowel sounds were found to be the primary indicator for determining GI functioning in the unconscious, critically ill patient. However, only 11.4% of nurses and 47.6% of doctors could make correct clinical judgments on the basis of their auscultatory findings. The attitudes of nurses and doctors differed significantly on whether BS auscultation was needed to monitor GI function for unconscious patients. Bowel sounds auscultation remains an important indicator of GI function. Distinct and feasible standards regarding BS auscultation and results interpretation need to be established.

Critical care nurses' self‐assessed patient observation skills: a cross‐sectional survey study

“…The Patient Observation Skills in Critical Care Nursing (POS‐CCN) instrument was developed for the study because of the lack of instruments in the field. The instrument's theoretical structure and content were formulated based on a qualitative descriptive study (Alastalo et al ., ) and prior literature (Currey and Botti, ; Hoffman et al ., ; Doig et al ., ; Haugdahl and Storli, ; Solberg et al ., ; European Federation of Critical Care Nursing Associations, ; Karra et al ., ; Li et al ., ; CC3N, ; Kydonaki et al ., ). POS‐CCN is a self‐assessment test measuring CCNs' patient observation skills in three different dimensions: (1) bio‐physiological foundation of observation, (2) skills in using observation methods (2·1: technical methods, 2·2: non‐technical methods) and (3) skills in recognizing the changing clinical condition.…”

Are Classic Bedside Exam Findings Required to Initiate Enteral Nutrition in Critically Ill Patients: Emphasis on Bowel Sounds and Abdominal Distension

“…Survey data suggest auscultatation of the abdomen is far from a universal examination technique with ∼80% of the surveyed 2298 critical care nurses in the United States reporting that they used this method 61,62 . Observational studies also indicate that wide variation in practice remains even when the abdomen is auscultated, with no single methodology regularly implemented 63–65 …”

Gastrointestinal dysmotility in critically ill patients

“…Clinical symptoms such as nausea, vomiting, pain, flatus, and distention may be underestimated in the vast majority of ICU patients. Amongst the clinical signs, bowel sound auscultation has been proposed as a means of monitoring bowel motility in critically ill patients, though its sensitivity and specificity in identifying ileus are relatively low [ 2 ]. Over the last few years, novel methods of electronic monitoring have been tested, aiming to eliminate the background noise and standardize the evaluation of bowel sounds, though at present they are used mainly for research proposals [ 3 ].…”